Social dimensions as resources in promoting academic well-being: the case study of the University of Foggia

Recently, scholars have focused more on changes in higher education, leading to significant insights into the working lives of academics and certain related processes, such as stress or well-being. The interest in academia is also justified by the role of universities as institutions that promote health and well-being, serving as a bridge between society, the world of work, and the local community. This study aims to identify social factors that can enhance the well-being of academic workers (lecturers and technical-administrative staff), highlighting how processes linked to social identity, based on the dynamics of identification with a territory or an organization, can serve as resources that promote well-being. Researchers conducted the survey on 198 workers at the University of Foggia (South Italy). Correlation and reliability assessments were first performed between the variables. Finally, a SEM study was completed. The goodness of fit of the model seems to be sufficient. The social aspects examined in the study, namely, organization identification, territorial well-being, and place attachment, were positively and significantly correlated with general well-being. Findings of the study demonstrated that for teaching and technical-administrative staff, among the key components for enhancing well-being in the academic setting was the social dimension of relationships, understood both inside and outside the university. Therefore, acting the belonging process to an area, implementing and strengthening relations with the social actors involved, as well as on the sense of belonging and identification with an organization, can have precise impact in enhancing well-being.

Introduction

This issue serves as a companion piece to a previous JPIC publication (n. 3, 2022), edited by Fortuna Procentese and Laura Migliorini, which served primarily to describe the individual and societal burdens associated with the current migrant crisis, and to present state-of-the-art methods for continuing research in this area. Conversely, the aims of the present volume are to deepen how existing psychological knowledge related to migration issues, inform future scientific, and technological responses as well as cultural and political advances and what additional research is required on this topic.

Women’s Experiences of Immigration Detention in Italy: Examining Immigration Procedural Fairness, Human Dignity, and Health

Recent decades have witnessed a growing number of states around the world relying on border control measures, such as immigration detention, to govern human mobility and control the movements of those classified as “unauthorised non-citizens.” In response to this, an increasing number of scholars from several disciplines, including psychologists, have begun to examine this phenomenon. In spite of the widespread concerns raised, few studies have been conducted inside immigration detention sites, primarily due to difficulties in gaining access. This body of research becomes even scanter when it comes to the experiences of detained women. This study is the first of its kind to have surveyed 93 women confined in an Italian immigration detention facility. A partial mediation model with latent variables was tested through partial least structural equation modelling (PLS-SEM). The findings revealed the negative impact that unfair immigration procedures have on detained women’s human dignity, which in turn negatively affects their self-rated physical and mental health. Overall, our study sheds light on the dehumanisation and damage to human dignity that immigration detention entails, as well as its negative impact on the health of those affected. This evidence reinforces the image of these institutions as sites of persistent injustice, while stressing the need to envision alternative justice-oriented forms to address human mobility.

Examining life in detention: A process of survey translation and adaptation through an ecological and collaborative approach

This paper illustrates the process we engaged in to translate and adapt a survey to examine life in an immigration detention center in Italy from the perspective of the migrants detained therein. The process consisted of: the forward translation of the original measure performed by four independent translators; a blind backward translation to identify misinterpretations or incorrect cross-cultural and contextual adaptations; a synthesis of all translations to obtain a semifinal version; the creation of an Expert Committee composed of scholars, practitioners, and migrants with experience of detention to assess equivalence and content validity; and, finally, pretesting with a group of 15 detained persons. Through this multi-step process we obtained a measure capable of grasping the context-specific meanings, needs and experiences that characterize life in detention. The challenges and benefits of a collaborative and ecological approach to measurement translation and adaption are discussed in the final section.

Promoting justice through community-based research: International case studies

Community-based participatory research (CBPR) approaches to promoting justice focus on working from the ground up and giving a voice to marginalized communities regarding their concerns, potential solutions, and how to address social justice issues that matter to them. The pursuit of justice is often related to efforts to attain personal as well as collective well-being. In this paper, we illustrate three exemplars of community psychologists' efforts to promote justice. Within each case study, we discuss the social and community context and examine how the researchers built partnerships and solidarity, developed ways of doing, and approached challenges and solutions. First, we present an example to promote economic justice through an entrepreneurship initiative developed in collaboration with young Black youth with disabilities in the United States. The second case illustrates an effort to promote reproductive justice in collaboration with Roma women and girls in Spain. The third exemplar depicts the use of life stories as a method to raise the voices of displaced, marginalized indigenous women in Peru. Based on these three case studies, we present a synthesis model of social justice. We also discuss implications for future studies emphasizing the importance of engaging community participants in research meaningful ways, developing sustainable partnerships, and decolonizing research.

The I COPPE Scale Short Form for measuring multidimensional well-being: Construct validity and reliability from US, Argentinian, and Italian large samples

The aim of this study is to present a short form of the I COPPE scale of multidimensional well-being. We conducted two studies, which include four samples collected across three countries, namely United States, Argentina, and Italy. In the pilot study we tested during the data analysis phase whether it was feasible to reduce the full I COPPE scale by omitting the items dealing with past well-being. Prompted by the positive results of the pilot study, we launched a final validation study with a sample of 2682 Italian people who completed the I COPPE scale short form, which is designed without items referring to past well-being. Results from a series of confirmatory factor analyses show that the I COPPE scale short form presents acceptable levels of construct validity and reliability. Moreover, the 7-factor correlated-trait model proved to be the best fit for the data. We discuss advantaged of using the I COPPE scale short form along with limitations and future recommendations.

Well-Being of Lesbian, Gay, Bisexual Youth: The Influence of Rural and Urban Contexts on the Process of Building Identity and Disclosure

The study investigates how the territorial community can influence the individual and social well-being of lesbian, gay, bisexual (LGB) youth and especially the recognition of their feelings and the construction of their own identity as well as their needs to be socially recognized. This research focuses on the experiences of 30 LGB individuals (23 males and 7 females), with a mean age of 25.07 years (SD = 4,578), living in urban and rural areas of Southern Italy. Focalized open interviews were conducted, and the Grounded Theory Methodology, supported by the Atlas.ti 8.0 software, was used for data analysis. The textual material was first coded, and then codes were grouped into five macro-categories: Freedom of identity expression in the urban and rural context, identity construction and acceptance process, need of aggregation and identification with the LGB community, role of the interpersonal relationship in the process of identity acceptance, socio-cultural context, and LGB psychological well-being. The results showed a condition common to the two contexts that we can define as “ghettoization.” The young LGB is alone in the rural area due to a lack of places and people to identify with and greater social isolation. On the contrary, although there are more opportunities in the urban area, young people feel stigmatized and ghettoized because “their places” are frequented exclusively by the lesbian, gay, bisexual, transexual, queer (LGBTQ) community. The work will extensively discuss the limitations of the research, future proposals, and the practical implications of the results.

Well-Being and the COVID-19 Pandemic

Abstract. The purpose of this systematic review is to analyze the COVID-19 pandemic’s effects through the lens of community psychology. Our study applied PRISMA methodology, and it was carried out using the PsycInfo, PubMed, Embase, and EBSCO databases utilizing the keywords “connectedness,” “resilience,” “shared action,” “social action,” “trust,” “individual well-being,” and “social well-being.” We selected 12 of 216 eligible publications based on the inclusion criteria. The results indicated that the role of trust in institutions and others is a protective factor for communities that experience crises, such as the COVID-19 pandemic. Moreover, developing social actions promoted connections and social support and that, in the absence of in-person communication, online communication promoted connections and reduced psychological distress and isolation. Finally, the study revealed that some psychosocial factors stem from declines in people’s well-being due to the pandemic and subsequent lockdowns. Furthermore, our findings highlighted the role of technology as a positive communication tool for promoting connectedness and social support, as well as the social function of trust in institutions. Our results suggested that community interactions at the local and virtual levels should be viewed as positive actions to support institutions in detecting the most effective social intervention measures to stimulate individual and community well-being during the pandemic. These findings may serve as a guide for health policymakers in their efforts to face the effects of the COVID-19 pandemic supporting beneficial strategies for social planning and effective public policies. Finally, both the strengths and limitations of the research will be discussed in depth.

Drawingvoice 2.0: classroom joint designing and Facebook interactions to develop reflexivity and awareness

Drawingvoice 2.0 is an instructional method of collaborative pencil and paper drawing to use in the school classroom, followed by Facebook interaction on the drawing produced in class. It is based on a participatory and meta reflective approach, explicitly aimed at deconstructing, negotiating, and reconstructing the meaning that students attribute to themselves regarding their professional expectations and educational pathways. In particular, the collaborative pencil and paper drawing allows for the student's emotional symbolisation processes underlying their educational pathway. Drawingvoice 2.0 induces a multidimensional cognitive and meta-cognitive process further supported by the following interaction on Facebook. Therefore, the World Wide Web is the added resource for sharing and deepening the classmates' discussion. Finally, Drawingvoice 2.0 supported structural group interaction and was an important supportive and instructional method to bring about transformational and developmental training practices. As the main result, in our experience, psychology students increased their reflectivity about their strengths and threats in being psychologists within their cultural contexts and potential positive resources underlying their choice. Drawingvoice 2.0 thus enhanced their self-awareness about the lights and shadows of their training and future professional career.

Community dimensions and emotions in the era of COVID-19

Following an ecological perspective, reactions to a disaster—such as the COVID‐19 pandemic—should be analysed in the interdependence between individual and community dimensions. The present study aims to analyse individual emotional dimensions (anxiety, joy, fear or depressive feelings) and their community dimensions (connectedness, emotional sharing and solidarity) with a longitudinal approach among university students from Italian universities. Participants were 746 university students at t1 (during the lockdown) and 361 at t2 (after the lockdown) recruited in six Italian universities from different areas of Italy. Comparing emotional dimensions in the two times, t2 is characterized by a generalized ambiguity: both happiness or joy because of the end of limitations and a kind of ‘post‐lockdown anxiety’ because of a sense of individual inadequacy in facing the return to normality, conducting daily activities and attending community spaces. Data confirms that after the so‐called ‘honeymoon phase’ in community dimensions (first phase of t1 time), a sort of ‘depressive reaction’ arises at t2: Italian university students seem more aware of the need for individual and social responsibility and that many events are not under their personal control. The reconstruction phase and exit from the emergency are perceived as necessary but also as a difficult and risky period. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

Psychological Lockdown Experiences: Downtime or an Unexpected Time for Being?

The spread of COVID-19 in Italy resulted in the implementation of a lockdown that obligated the first time the general populace to remain at home for approximately two months. This lockdown interrupted citizens' professional and educational activities, in addition to closing shops, offices and educational institutions. The resulting changes in people's daily routines and activities induced unexpected changes in their thoughts, feelings and attitudes, in addition to altering their life perceptions. Consequently, the present study explores how young adults perceived their lives under lockdown during the final week of March 2020, when the reported number of daily coronavirus infections reached its peak in Italy. The research was carried out among 293 university students (234 women and 59 men) with an average age of 20.85 years old (SD = 3.23). The researchers asked participants to describe the emotions, thoughts and experiences that characterized their time under lockdown. The study analyzed specific narratives related to time and space using grounded theory methodology, which was applied using Atlas 8 software, leading to the creation of 68 codes. The study organized these codes into three specific categories: confined in the present, confined in the past, and striving toward one's goals. Finally, the researchers also created a core-category labeled "continuity of being." The results showed that the closure of open spaces caused a division in participants' perceptions of time continuity, with many viewing themselves as feeling fragmented and as living the present in a static and fixed way. Additionally, participants also saw the present as being discontinuous from the past, while, simultaneously, projecting toward the future and the changes it might bring. Finally, this study examined further implications surrounding individual projecting among young people in greater depth.

Italian Community Psychology in the COVID-19 Pandemic: Shared Feelings and Thoughts in the Storytelling of University Students

This study investigated how young Italian people experienced the period of peak spread of COVID-19 in their country by probing their emotions, thoughts, events, and actions related to interpersonal and community bonds. This approach to the pandemic will highlight social dimensions that characterized contextual interactions from the specific perspective of Community Psychology. The aim was to investigate young people's experiences because they are the most fragile group due to their difficulty staying home and apart from their peers and because they are, at the same time, the most potentially dangerous people due to their urge to gather in groups. The research involved 568 university students, 475 females, and 93 males, with an average age of 21.82 years (SD = 4.836). The collected data were analyzed with the Grounded Theory Methodology, using the Atlas 8.0 software. From the textual data, representative codes were defined and grouped into 10 categories, which reflect the individuals' prosocial attitudes, behaviors, and values. These categories formed three macro-categories, called: "Collective Dimensions," which includes Connectedness, Solidarity, Italian-ness, Social Problems, and Collective Mourning; "Prosocial Orientation," which includes Trust and Hope; and "Collective Values," which includes Values of Freedom, Respect of Social Rules, and Civic-Mindedness. All these macro-categories are indicative of the shared feelings experienced by Italians during the first time of the pandemic. Further practical implications of these results will be discussed, including a consideration of the risk of developing distress and improving well-being, as well as promoting preventive behaviors.

Downside: The Perpetrator of Violence in the Representations of Social and Health Professionals

Gender-based violence is a widespread phenomenon and pandemic that affects women's lives. Many interventions have been activated for perpetrators, but the dropout rate is still high. In order to draw up guidelines for responsibly and sustainably dealing with the phenomenon, this study is aimed at investigating the professionals' perception of the perpetrator as a useful element in designing innovative intervention policies. Open interviews were carried out with welfare and health professionals and the Grounded Theory Methodology was used to analyze the collected data. These results detect attitudes of social health personnel and their feelings of impotence towards gender-based perpetrators because of the emergence of an inevitable repetitiveness of the violent behavior, as well as the "normality of violence" in a patriarchal culture and its "transversality". This reflective knowledge allows for the opportunity to develop best transformative attitudes toward the phenomenon. According to the results, it is urgent to establish an active and convinced alliance with the healthy part of the man, through specific prevention paths, in order to activate an authentic motivation for change and its sustainability.

Combatting Intimate Partner Violence: Representations of Social and Healthcare Personnel Working with Gender-Based Violence Interventions

Intimate partner violence (IPV) has been declared a global epidemic by the World Health Organization. Although the attention paid to both the perpetrators and victims of gender-based violence has increased, scientific research is still lacking in regard to the representations of operators involved in interventions and management. Therefore, the following study explores how the representations of operators affect how gender violence can be managed and combatted through an ecological approach to this phenomenon, in addition to highlighting the roles of organizational-level services and their cultural and symbolic substrates. In total, 35 health and social professionals were interviewed and textual materials were analyzed by thematic analysis. The evidence suggests that services contrasting gender-based violence utilize different representations and management approaches. The authors hope that these differences can become a resource, rather than a limitation, when combatting gender-based violence through the construction of more integrated networks and a greater dialogue among different services, in order to make interventions designed to combat gender-based violence more effective.

The Use of Partial Least Squares-Path Modelling to Understand the Impact of Ambivalent Sexism on Violence-Justification among Adolescents

Gender violence is generally conceived as a phenomenon concerning only adults. Nonetheless, it is also perpetrated within teenagers’ relationships, as many empirical studies have shown. We therefore have focused our attention on a non-probabilistic sample consisting of 400 adolescents living in Naples (Italy), to study the association between sexism and the justification of violent attitudes. Generally, sexism is recognised as a discriminatory attitude towards people, based on their biological sex. However, it is conventional to talk about sexism as a prejudice against women. The Ambivalent Sexism Inventory (ASI) for adolescents was used to evaluate the two dimensions of ambivalent sexism, i.e., hostile sexism (HS) and benevolent sexism (BS). Moreover, the questionnaire regarding attitudes towards diversity and violence (CADV) was administered to assess participants’ attitudes towards violence. A Partial Least Square–Second Order Path Model reveals that girls’ ambivalent sexism is affected more by benevolent sexism than hostile sexism. On the contrary, among boys, hostile sexism has a higher impact. Finally, benevolent sexist girls justify domestic violence more than boys do.

Children Witnessing Domestic Violence in the Voice of Health and Social Professionals Dealing with Contrasting Gender Violence

Witnessing domestic violence (WDV) is recognized by the Istanbul Convention as psychological abuse that has dramatic consequences on the psychophysical health of children. Therefore, professionals who form the support network for WDV victims play a very fundamental role. In order to draw up useful guidelines for services dealing with WDV, and to give children more awareness of supportive settings, this study analyzes WDV in the perception of health and welfare professionals to enhance their skills and strategies for contrasting gender violence. Sixteen Neapolitan specialists dealing with WDV children were interviewed. A theoretical intentional sampling was used. Narrative focused interviews were carried out, transcribed verbatim and analyzed through the grounded theory methodology, using the ATLAS.ti 8 software (Scientific Software Development GmbH, Berlin, Germany). We assigned 319 codes and grouped these into 10 categories and 4 macro-categories. The analysis of the texts led to the definition of the core category as "The Crystal Fortress". It summarizes the image of the WDV children as described by the professionals working in contrasting domestic violence. In this structure the parental roles of protection and care (fortress) are suspended and everything is extremely rigid, fragile and always at risk of a catastrophe. It also symbolizes the difficult role of health professionals in dealing with such children and their families. For WDV children, protective factors guarantee solid development and supportive settings help them to learn proper emotional responsiveness and expressiveness and to develop their skills in talking with adults while avoiding negative consequences.

“Yes, But Somebody Has to Help Them, Somehow:” Looking at the Italian Detention Field through the Eyes of Professional Nonstate Actors

Although migration-related detention has proliferated around the world, little is known about life inside these sites of confinement for illegalized non-citizens. Building on 34 months of fieldwork, this article examines the lived experiences of center staff and external civil-society actors engaged within Rome’s detention center. We discuss the emotional, ethical, and political challenges faced by these professional actors in their everyday work and their relationship with detainees. Our aim is to shed light on psychosocial life in detention and the intersections between humanitarian and security logics in this setting. In doing so, we problematize the idea that “humanizing detention” can be a solution for change.

Ending Intimate Partner Violence (IPV) and Locating Men at Stake: An Ecological Approach

Interventions for ending intimate partner violence (IPV) have not usually provided integrated approaches. Legal and social policies have the duty to protect, assist and empower women and to bring offenders to justice. Men have mainly been considered in their role as perpetrators to be subjected to judicial measures, while child witnesses of violence have not been viewed as a direct target for services. Currently, there is a need for an integrated and holistic theoretical and operational model to understand IPV as gender-based violence and to intervene with the goal of ending the fragmentation of existing measures. The EU project ViDaCS-Violent Dads in Child Shoes-which worked towards the deconstruction and reconstruction of violence's effects on child witnesses, has given us the opportunity to collect the opinions of social workers and child witnesses regarding violence. Therefore, the article describes measures to deal with IPV, proposing functional connections among different services and specific preventative initiatives. Subsequently, this study will examine intimate partner violence and provide special consideration to interventions at the individual, relational, organizational and community levels. The final goal will be to present a short set of guidelines that take into account the four levels considered by operationalizing the aforementioned ecological principles.

Ecology of Sites of Confinement: Everyday Life in a Detention Center for Illegalized Non-citizens

Drawing on almost 3 years of fieldwork, comprising qualitative interviews and ethnographic observations, this study provides an exploration into the detention of illegalized non-citizens in Italy. Taking the largest detention center as a case study, the fabric of everyday life and the lived experiences of people, both detainees and professional actors, are the focus of examination. An ecological community psychology framework, with a focus on justice, guided the data collection, analysis, and interpretation. Findings highlight the oppressive qualities of detention, and its ripple effects on people's life spaces. Scarcity of resources, activities, and information created a very distressing environment for detainees, also enhancing feelings of powerlessness and frustration in professionals willing to assist them. Uncertainty and instability, rather than coercion or discipline, emerged as modes of governing and dominating. Bound in a different space and time, detainees were turned into unwanted and expendable others, their confinement becoming a means to extract profit from them. Yet, people languishing in these sites displayed an extraordinary ability to cope with, resist, and challenge the persisting conditions of injustice they endured. We conclude by highlighting the potential of the proposed framework, and discussing broader implications of our findings and avenues for research and action.

Measuring subjective well-being from a multidimensional and temporal perspective: Italian adaptation of the I COPPE scale

BACKGROUND

The objective of this study is to present the psychometric and cultural adaptation of the I COPPE scale to the Italian context. The original 21-item I COPPE was developed by Isaac Prilleltensky and colleagues to integrate a multidimensional and temporal perspective into the quantitative assessment of people's subjective well-being. The scale comprises seven domains (Overall, Interpersonal, Community, Occupation, Psychological, Physical, and Economic well-being), which tap into past, present, and future self-appraisals of well-being.

METHODS

The Italian adapted version of the I COPPE scale underwent translation and backtranslation procedure. After a pilot study was conducted on a local sample of 683 university students, a national sample of 2432 Italian citizens responded to the final translated version of the I COPPE scale, 772 of whom re-completed the same survey after a period of four months. Respondents from both waves of the national sample were recruited partly through on-line social networks (i.e. Facebook, Twitter, and SurveyMonkey) and partly by university students who had been trained in Computer-Assisted Survey Information Collection.

RESULTS

Data were first screened for non-valid cases and tested for multivariate normality and missing data. The correlation matrix revealed highly significant correlation values, ranging from medium to high for nearly all congeneric variables of the I COPPE scale. Results from a series of nested and non-nested model comparisons supported the 7-factor correlated-traits model originally hypothesised, with factor loadings and inter-item reliability ranging from medium to high. In addition, they revealed that the I COPPE scale has strong internal reliability, with composite reliability always higher than .7, satisfactory construct validity, with average variance extracted nearly always higher than .5, and and full strict invariance across time.

CONCLUSIONS

The Italian adaptation of the I COPPE scale presents appropriate psychometric properties in terms of both validity and reliability, and therefore can be applied to the Italian context. Some limitation and recommendations for future studies are discussed.

Beyond disciplinary boundaries: speaking back to critical knowledges, liberation, and community

This article explores critical directions for forging new disciplinary traditions within community psychology, as discussed by a panel at the conclusion of the 6th International Conference on Community Psychology (ICCP 2016). The conference itself was constructed as an enactment of a decolonizing approach, looking at the entire globalized system from the African continent and centring knowledges produced by Africans and the diaspora. Several panellists were invited to offer their reflections on the emerging discussions, and absences or silences they observed at the conference, as well as how community research and action can develop a research and teaching programme that is liberatory. Panellists’ comments pointed to the importance of the decolonization project globally and the implications of decoloniality for community research and action. The challenge for community research and action is to build alliances and networks across space and time, and with various social movements. The discipline needs to centre and draw out the voices of those who have been excluded, to retrieve and reclaim ways of knowing, being, and doing because these are key to tackling the coloniality of power and to forging new ways of doing ethical and just community research and action.

From “Gomorrah domain” to “Don Peppe Diana Lands”. A southern Italian experience of work-based liberation, community networking, and well being

The article describes working experiences in relation to empowering activities, which have been carried out in a local community in the province of Caserta (in Southern Italy), a place characterized by the widespread presence of organized criminal groups. In this study, workplace is intended as a community network aimed at the promotion of coscientization, liberation, and well-being. Specifically, this paper features initiatives and projects aimed at establishing new community values through a re-construction of a work-based social system standing against criminal clans, which tend to dominate not only economical transactions but also civil life.

The tracking control system of the VLT Survey Telescope

The VLT survey telescope is the latest telescope installed at European Southern Observatory's Paranal observatory that is considered one of the best sites for optical astronomy for the excellent seeing conditions. The exceptional quality of the site imposes tight requirements for the telescope tracking system that shall perform very well to fully exploit the extreme sharpness of the Chilean sky. We describe the specific solutions adopted for pointing, servo and guiding systems and the results obtained during the commissioning of the telescope. The hardware implementation relies on industry components and the control solutions privilege both the performance and the future maintainability of the system.

Increased risk for non-autoimmune hypothyroidism in young patients with congenital heart defects

CONTEXT

Newborns with congenital hypothyroidism (CH) have an increased risk for congenital heart defects (CHD) due to a common embryonic developmental program between thyroid gland and heart and great vessels.

OBJECTIVE

Our objective was to investigate the prevalence and origin of thyroid disorders in young patients with CHD.

DESIGN AND SETTING

We conducted a prospective observational study between January 2007 and January 2009 in academic Pediatric Cardiosurgery and Endocrinology.

PATIENTS

Patients included 324 children (164 males, 160 females, aged 0.2-15.4 yrs) with CHD.

INTERVENTION

Subjects underwent hormonal and genetic screening.

MAIN OUTCOME MEASURES

Serum TSH and thyroid hormone levels were assessed.

RESULTS

Two CHD patients were diagnosed with CH at the neonatal screening (1:162). Mild hypothyroidism (serum TSH > 4.0 μU/ml) was diagnosed and confirmed 6 months later [TSH = 5.4 ± 1.5 μU/ml; free T(4) = 1.3 ± 0.2 ng/dl (normal values 0.8-1.9)] in 37 children (11.5%) who were negative at neonatal screening. Hypothyroidism was not related to type of CHD, whereas TSH levels positively correlated with serum N-terminal pro-type B natriuretic peptide levels. Biochemical and ultrasound findings consistent with thyroid autoimmunity were present in three of 37 hypothyroid children (8.1%). One patient had hemiagenesis (2.7%). Variations in candidate genes were screened in CHD patients. NKX2.5 coding sequence was normal in all samples. A 3-Mb microdeletion in 22q11.2 was detected in three patients (8.3%), whereas only known polymorphisms were identified in TBX1 coding sequence.

CONCLUSIONS

CHD patients have an increased risk for both CH (10-fold higher) and acquired mild hypothyroidism (3-fold higher). Unrecognized mild hypothyroidism may negatively affect the outcome of CHD children, suggesting that thyroid function should be repeatedly checked. Thyroid autoimmunity and 22q11.2 microdeletions account for small percentages of these cases, and still unknown mechanisms underline such a strong association.

[Infective endocarditis in patients with congenital heart disease]

The incidence of infective endocarditis (IE) in patients with congenital heart disease (CHD) is higher than in general population; this is a major problem considering the continuous expansion of such group of patients. Generally the more complex is the congenital heart disease the higher is the risk of IE. The aetiology, clinical features, complications, basis for diagnosis and treatment of IE in CHD patients don't differ from those in acquired cardiac disease; however, right-sided IE is more frequent in CHD patients. Due to the complex anatomy or presence of artificial material in many CHD, the transesophageal echocardiogram is extremely useful although echocardiographic assessment remains difficult. Prognosis is better than in other forms of IE with a mortality rate <10%. Primary prevention is crucial: a good oral-dental hygiene and regular dental review are as important as antibiotic prophylaxis; however this awareness in the CHD population is still not satisfactorily spread due to an educational problem. New IE guidelines from International Cardiology Societies emphasize the role of primary prevention and limit antibiotic prophylaxis to the highest risk patients undergoing the highest risk procedures. This article reviews the main reasons justifying the revision of previous IE guidelines, focuses on criteria to select CHD patients requiring antibiotic prophylaxis and gives information about antibiotic therapy to use.

[Cardiopulmonary exercise test in adults with congenital heart disease]

Cardiopulmonary exercise testing (CPET) gives important information about functional capacity by direct measurement of exercise respiratory gas exchange. It provides assessment of the integrative exercise responses involving the cardiovascular, respiratory and muscle-skeletal systems which are not adequately investigated through the measurement of individual organ system function. CPET involves measurements of oxygen uptake (VO2), carbon dioxide production (VCO2) and several ventilatory measures. CPET is increasingly being used as a clinical tool to determine functional capacity, prognosis and potential need for medical or surgical interventions in patients affected by congenital heart disease (CHD). Also in this population, peak VO2 and slope VE/VCO2 are the most predictive parameters in terms of mortality and need of hospitalization. Cyanotic patients with Esisenmenger syndrome show the worst functional limitation and consequently the worst prognosis. This article provides basic and practical information about CPET and focuses on its interpretation in patients with CHD.

A new 2D-based method for myocardial velocity strain and strain rate quantification in a normal adult and paediatric population: assessment of reference values

BACKGROUND

Recent advances in technology have provided the opportunity for off-line analysis of digital video-clips of two-dimensional (2-D) echocardiographic images. Commercially available software that follows the motion of cardiac structures during cardiac cycle computes both regional and global velocity, strain, and strain rate (SR). The present study aims to evaluate the clinical applicability of the software based on the tracking algorithm feature (studied for cardiology purposes) and to derive the reference values for longitudinal and circumferential strain and SR of the left ventricle in a normal population of children and young adults.

METHODS

45 healthy volunteers (30 adults: 19 male, 11 female, mean age 37 +/- 6 years; 15 children: 8 male, 7 female, mean age 8 +/- 2 years) underwent transthoracic echocardiographic examination; 2D cine-loops recordings of apical 4-four 4-chamber (4C) and 2-chamber (2C) views and short axis views were stored for off-line analysis. Computer analyses were performed using specific software relying on the algorithm of optical flow analysis, specifically designed to track the endocardial border, installed on a Windows based computer workstation. Inter and intra-observer variability was assessed.

RESULTS

The feasibility of measurements obtained with tissue tracking system was higher in apical view (100% for systolic events; 64% for diastolic events) than in short axis view (70% for systolic events; 52% for diastolic events). Longitudinal systolic velocity decreased from base to apex in all subjects (5.22 +/- 1.01 vs. 1.20 +/- 0.88; p < 0.0001). Longitudinal strain and SR significantly increased from base to apex in all subjects (-12.95 +/- 6.79 vs. -14.87 +/- 6.78; p = 0.002; -0.72 +/- 0.39 vs. -0.94 +/- 0.48, p = 0.0001, respectively). Similarly, circumferential strain and SR increased from base to apex (-21.32 +/- 5.15 vs. -27.02 +/- 5.88, p = 0.002; -1.51 +/- 0.37 vs. -1.95 +/- 0.57, p = 0.003, respectively). Values of global systolic SR, both longitudinal and circumferential, were significantly higher in children than in adults (-1.3 +/- 0.2, vs. -1.11 +/- 0.2, p = 0.006; -1.9 +/- 0.6 vs. -1.6 +/- 0.5, p = 0.0265, respectively). No significant differences in longitudinal and circumferential systolic velocities were identified for any segment when comparing adults with children.

CONCLUSION

This 2D based tissue tracking system used for computation is reliable and applicable in adults and children particularly for systolic events. Measured with this technology, we have established reference values for myocardial velocity, Strain and SR for both young adults and children.